NASH Presence is Associated with a Lower Weight Loss One and 2 Years After Bariatric Surgery in Women with Severe Obesity

• Published in: Obesity surgery Vol. 32; no. 10; pp. 3313 - 3323
• Main Authors: Sabench, Fàtima, Bertran, Laia, Vives, Margarita, París, Marta, Aguilar, Carmen, Martínez, Salomé, Binetti, Jessica, Real, Monica, Alibalic, Alja, Richart, Cristóbal, del Castillo, Daniel, Auguet, Teresa
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.10.2022; Springer Nature B.V
• Subjects: Diabetes; Gastrointestinal surgery; Medicine; Medicine & Public Health; Obesity; Original Contributions; Surgery; Weight control; Obesity; T2DM; NAFLD; NASH; Bariatric surgery; Weight loss
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-022-06175-w

Purpose Given that obesity is a major medical problem associated with non-alcoholic fatty liver disease and the lack of studies on postsurgery weight loss according to hepatic histology, we aimed to analyse weight loss indicators according to non-alcoholic steatohepatitis (NASH) presence one and 2 years postsurgery. Materials and Methods The weight loss pattern of 410 women with severe obesity (SO) was analysed after sleeve gastrectomy (SG, n  = 191) and Roux-en-Y gastric bypass (RYGB, n  = 219) according to NASH presence at baseline and at 12 and 24 months postsurgery. Weight loss indicators: expected BMI (eBMI), excess BMI loss percentage (%EBMIL), total weight loss percentage (%TWL) and alterable weight loss percentage (%AWL). Results Unlike RYGB, after SG, a higher percentage of NASH patients do not reach the eBMI 2 years postsurgery. %TWL and %AWL presented no differences after RYGB despite the presence of NASH. After SG, there is a worse ponderal evolution of all indicators analysed in the presence of NASH. Unlike SG, diabetic patients lose less weight than non-diabetic patients after RYGB. The presence of NASH in diabetics had no impact on weight loss indicators, but in non-diabetics, it had an impact, particularly in the SG group. Conclusion The presence of NASH suggests a worse weight loss pattern through all the analysed indicators one and 2 years after SG in women. The presence of T2DM appears to result in less weight loss after RYGB, but only non-diabetic women presenting NASH lose less weight that non-diabetic women in the absence of NASH after SG. Graphical abstract